Cardiovascular Health, Quality of Life Improves After Cushing’s Syndrome Surgery, Study Shows

Heart problems in Cushing’s syndrome patients may be partially reversed after tumor removal surgery, new research shows.

For most patients in the study, the surgery also improved quality of life, mental and physical health, anxiety, and depression. However, 1 in 3 patients showed worse anxiety and depression scores, researchers found.

The study, “Cardiovascular Functional Status During Overt And After Cure Of Endogenous Cushing’s Syndrome: First Results From A Prospective Longitudinal Study,” was presented at the ENDO 2018 Meeting recently held in Chicago.

Cushing’s syndrome is associated with a higher risk for cardiovascular diseases, but whether this risk drops after surgery for Cushing’s syndrome is still unclear.

To address this, researchers at the University Hospital Wuerzburg in Germany assessed the cardiovascular function of Cushing’s syndrome patients who underwent surgery to remove the underlying tumor.

In the study, 17 patients underwent a series of tests to measure cardiovascular function: echocardiography, an ultrasound scan of the heart; monitoring of blood pressure and heart activity for 24 hours; and evaluation of the endothelium — the inner cellular lining of blood and lymphatic vessels — using noninvasive techniques.

The tests were performed at the initial diagnosis and six months after surgery.

Patients also answered questionnaires assessing their quality of life, mental and physical health, general health, anxiety, and depression.

The time between surgery and cure — when cortisol levels are within normal range — was about 8.9 months. Compared with the initial diagnosis, patients had a significant decrease in body mass index (BMI) and waist-to-hip-ratio after surgery. Patients also showed a tendency toward lower levels of LDL, known as the “bad” cholesterol — 123 after surgery versus 120 at initial diagnosis.

An ultrasound scan of the heart showed that patients’ systolic function — the part of the heart pumping blood to the rest of the body — was significantly improved after surgery. Other heart parameters, including a condition linked to increased resistance to the filling of one or both heart ventricles, remained the same.

High blood pressure also decreased, with cured patients requiring fewer antihypertensives.

Researchers detected no major changes in heart rhythms — pauses or arrhythmias — and found only moderate changes in endothelial abnormalities.

Most patients experienced significant improvements in quality of life, mental and physical health, anxiety, and depression. And while not statistically significant, researchers found improvements linked to social functioning, pain, and general health.

“However, a relevant number of formally cured subjects showed a worsening of their anxiety and depression indices (29 and 35%),” they wrote.

These findings suggest that several of the heart problems seen in Cushing’s syndrome patients are partially reversible with curative surgery. Additionally, while patients’ quality of life and mental health improve with time, some patients may still experience depression and anxiety, at least in the short term, the study concluded.